Prognosis

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Periodontal Prognosis


Discuss the concept of prognosis including how its determine and its relevance.

Prognosis is a prediction of probable course, duration and outcome of disease based on general knowledge and pathogenesis of disease and the presence of risk factors for the disease. It is established after diagnosis and after treatment plan. Clinical and radiographic findings should be used. An overall prognosis of dentition can be determined as well as for individual teeth.


Factors in determining prognosis:


1. Overall clinical factors: patient age, disease activity, plaque control, patient compliance
2. Systemic and Environmental Factors: smoking, systemic disease or condition, genetic factors, stress.
3. Local Factors: plaque and calculus, subgingival restorations, anatomical factors, tooth mobility.
4. Prosthetic and restorative factors: caries, non-vital teeth, root resorption.

Prognosis


1. Excellent:


  • No bone loss
  • Excellent gingival condition
  • Good patient cooperation
  • No systemic or environmental factors.

2. Good:

One or more of the following:

  • -Adequate remaining bone support
  • -Adequate possibilities to control plaque
  • -Adequate patient cooperation
  • -No systemic or environmental factors
  • -If systemic factors are present, they are well controlled

3. Fair:

One or more of the following:

  • -Less than adequate remaining bone support
  • -Some tooth mobility
  • -Class I furcation involvement
  • -Adequate maintenance possible
  • -Acceptable patient cooperation
  • -Presence of limited systemic or environmental factors

4. Poor:

One or more of the following:

  • -Moderate to advanced bone loss
  • -Tooth mobility
  • -Class I or II furcations
  • -Difficult to maintain areas
  • -Doubtful patient cooperation
  • -Presence of systemic or environmental factors

5. Questionable:

One or more of the following:

  • -Advanced bone loss
  • -Class II or III furcations
  • -Tooth mobility
  • -Inaccessible areas
  • -Presence of systemic or environmental factors

6. Hopeless:

One or more of the following:

  • -Advanced bone loss
  • -Non maintainable areas
  • -Extractions indicated
  • -Presence of uncontrolled systemic or environmental factors.